- The Impact of the Financial Crisis on Lifestyle Health Determinants Among Older Adults Living in the Mediterranean Region: The Multinational MEDIS Study (2005-2015)
-
Alexandra Foscolou, Stefanos Tyrovolas, George Soulis, Anargiros Mariolis, Suzanne Piscopo, Giuseppe Valacchi, Foteini Anastasiou, Christos Lionis, Akis Zeimbekis, Josep-Antoni Tur, Vassiliki Bountziouka, Dimitra Tyrovola, Efthimios Gotsis, George Metallinos, Antonia-Leda Matalas, Evangelos Polychronopoulos, Labros Sidossis, Demosthenes B. Panagiotakos
-
J Prev Med Public Health. 2017;50(1):1-9. Published online December 19, 2016
-
DOI: https://doi.org/10.3961/jpmph.16.101
-
-
13,694
View
-
343
Download
-
34
Crossref
-
 Abstract
 PDF
- Objectives
By the end of the 2000s, the economic situation in many European countries started to deteriorate, generating financial uncertainty, social insecurity and worse health status. The aim of the present study was to investigate how the recent financial crisis has affected the lifestyle health determinants and behaviours of older adults living in the Mediterranean islands.
Methods
From 2005 to 2015, a population-based, multi-stage convenience sampling method was used to voluntarily enrol 2749 older adults (50% men) from 20 Mediterranean islands and the rural area of the Mani peninsula. Lifestyle status was evaluated as the cumulative score of four components (range, 0 to 6), that is, smoking habits, diet quality (MedDietScore), depression status (Geriatric Depression Scale) and physical activity.
Results
Older Mediterranean people enrolled in the study from 2009 onwards showed social isolation and increased smoking, were more prone to depressive symptoms, and adopted less healthy dietary habits, as compared to their counterparts participating earlier in the study (p<0.05), irrespective of age, gender, several clinical characteristics, or socioeconomic status of the participants (an almost 50% adjusted increase in the lifestyle score from before 2009 to after 2009, p<0.001).
Conclusions
A shift towards less healthy behaviours was noticeable after the economic crisis had commenced. Public health interventions should focus on older adults, particularly of lower socioeconomic levels, in order to effectively reduce the burden of cardiometabolic disease at the population level.
-
Summary
-
Citations
Citations to this article as recorded by  - Lifestyle changes during the economic crisis: a Sri Lankans survey
Piumika Sooriyaarachchi, Ranil Jayawardena
Journal of Public Health.2025; 33(2): 427. CrossRef - The Role of Food Security in Mediterranean Diet Adherence Among Adolescents: Findings from the EHDLA Study
Andrea Aquino-Blanco, Estela Jiménez-López, Desirée Victoria-Montesinos, Héctor Gutiérrez-Espinoza, Jorge Olivares-Arancibia, Rodrigo Yañéz-Sepúlveda, Nerea Martín-Calvo, José Francisco López-Gil
Foods.2025; 14(3): 414. CrossRef - The Impact of the Economic Crisis on the Eating Behavior and Lifestyle of the Young Lebanese Population
Rola El Cheikh, Ali Al Khatib, Samer Sakr, Suzana Salhab, Imtithal Sheet
The Open Public Health Journal.2024;[Epub] CrossRef - Motivation for health behaviour: A predictor of adherence to balanced and healthy food across different coastal Mediterranean countries
Marija Ljubičić, Marijana Matek Sarić, Ivo Klarin, Ivana Rumbak, Irena Colić Barić, Jasmina Ranilović, Ayman EL-Kenawy, Maria Papageorgiou, Elena Vittadini, Maša Černelič Bizjak, Raquel Guiné
Journal of Functional Foods.2022; 91: 105018. CrossRef - Nutritional status and associated factors of older persons in sub-Saharan Africa: a scoping review
Paul Obeng, Henneh Kwaku Kyereh, Jacob Owusu Sarfo, Edward Wilson Ansah, Priscilla Yeye Adumoah Attafuah
BMC Geriatrics.2022;[Epub] CrossRef - Post-lockdown changes in diet in Italy and the USA: Return to old habits or structural changes?
Gabriele Scozzafava, Caterina Contini, Francesca Gerini, Leonardo Casini
Agricultural and Food Economics.2022;[Epub] CrossRef - Adherence to the Mediterranean diet and weight status in children: the role of parental feeding practices
Vassiliki Costarelli, Maria Michou, Demosthenes B. Panagiotakos, Christos Lionis
International Journal of Food Sciences and Nutrition.2021; 72(1): 112. CrossRef - Consumers’ attitude toward dietary supplements and functional food: a prospective survey in a Greek population sample
Evangelia Tsartsou, Nikolaos Proutsos, Iakovos Papadopoulos, Vangelis Tzouvelekas, Elias Castanas, Marilena Kampa
Hormones.2021; 20(1): 177. CrossRef - The CASSIOPEA Study (Economic Crisis and Adherence to the Mediterranean diet: poSSIble impact on biOmarkers of inflammation and metabolic PhEnotypes in the cohort of the Moli-sAni Study): Rationale, design and characteristics of participants
Marialaura Bonaccio, Simona Costanzo, Augusto Di Castelnuovo, Mariarosaria Persichillo, Amalia De Curtis, Marco Olivieri, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello
Nutrition, Metabolism and Cardiovascular Diseases.2021; 31(4): 1053. CrossRef - Impacts of the 2008 Great Recession on dietary intake: a systematic review and meta-analysis
Rosemary H. Jenkins, Eszter P. Vamos, David Taylor-Robinson, Christopher Millett, Anthony A. Laverty
International Journal of Behavioral Nutrition and Physical Activity.2021;[Epub] CrossRef - Household food spending, parental and childhood’s diet quality, in financial crisis: a cross-sectional study in Greece
Rena I Kosti, Aikaterini Kanellopoulou, Venetia Notara, George Antonogeorgos, Andrea Paola Rojas-Gil, Ekaterina N Kornilaki, Areti Lagiou, Demosthenes B Panagiotakos
European Journal of Public Health.2021; 31(4): 822. CrossRef - Changes in lifestyle, diet, and body weight during the first COVID 19 ‘lockdown’ in a student sample
K. Palmer, A. Bschaden, N. Stroebele-Benschop
Appetite.2021; 167: 105638. CrossRef - A Generation Shift in Mediterranean Diet Adherence and Its Association with Biological Markers and Health in Dalmatia, Croatia
Jelena Šarac, Dubravka Havaš Auguštin, Mario Lovrić, Sarah Stryeck, Iva Šunić, Natalija Novokmet, Saša Missoni
Nutrients.2021; 13(12): 4564. CrossRef - Sex and age in relation to health and nutrition literacy levels in a sample of Greek adults
Maria Michou, Demosthenes B. Panagiotakos, Christos Lionis, Vassiliki Costarelli
International Journal of Health Promotion and Education.2020; 58(5): 229. CrossRef - Changes in the Provision of Family Care to Frail Older People in Familistic Welfare States: Lessons From Israel and Italy
Aviad Tur-Sinai, Georgia Casanova, Giovani Lamura
Journal of Aging and Health.2020; 32(9): 972. CrossRef - Economic crises, behavioral changes and hospitalization due to affective disorders in Brazil between 2003 and 2017: a nationwide cross-sectional study
André Oliveira Werneck, Rômulo Araújo Fernandes, Danilo Rodrigues Silva
Sao Paulo Medical Journal.2020; 138(2): 167. CrossRef - A Decade of Crisis in the European Union: Lessons from Greece*
Alexia Katsanidou, Zoe Lefkofridi
JCMS: Journal of Common Market Studies.2020; 58(S1): 160. CrossRef - Impact of a Moderately Hypocaloric Mediterranean Diet on the Gut Microbiota Composition of Italian Obese Patients
Silvia Pisanu, Vanessa Palmas, Veronica Madau, Emanuela Casula, Andrea Deledda, Roberto Cusano, Paolo Uva, Sarah Vascellari, Francesco Boi, Andrea Loviselli, Aldo Manzin, Fernanda Velluzzi
Nutrients.2020; 12(9): 2707. CrossRef - The association of sodium intake with successful aging, in 3,349 middle-aged and older adults: Results from the ATTICA and MEDIS cross-sectional epidemiological studies
Alexandra Foscolou, Elena Critselis, Stefanos Tyrovolas, Christina Chrysohoou, Nenad Naumovski, Loukianos Rallidis, Evangelos Polychronopoulos, Antonia-Leda Matalas, Labros S. Sidossis, Demosthenes Panagiotakos
Nutrition and Healthy Aging.2020; 5(4): 287. CrossRef - Access to health care in an age of austerity: disabled people’s unmet needs in Greece
Elena S. Rotarou, Dikaios Sakellariou
Critical Public Health.2019; 29(1): 48. CrossRef - Socioeconomic and psychosocial determinants of adherence to the Mediterranean diet in a general adult Italian population
Emilia Ruggiero, Augusto Di Castelnuovo, Simona Costanzo, Mariarosaria Persichillo, Francesca Bracone, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello, Marialaura Bonaccio, Licia Iacoviello, Americo Bonanni, Marialaura Bonac
European Journal of Public Health.2019; 29(2): 328. CrossRef - Development & validation of the Greek version of the nutrition literacy scale
Maria Michou, Demosthenes B. Panagiotakos, Vassiliki Costarelli
Mediterranean Journal of Nutrition and Metabolism.2019; 12(1): 61. CrossRef - Cardiovascular disease risk status during the years of the financial crisis: The Greek case
Demosthenes Panagiotakos, Alexandra Foscolou
Hellenic Journal of Cardiology.2019; 60(3): 189. CrossRef - Development and validation of the Greek version of the comprehensive parental feeding questionnaire
Maria Michou, Demosthenes B. Panagiotakos, Eirini Mamalaki, Maria Yannakoulia, Vassiliki Costarelli
Mediterranean Journal of Nutrition and Metabolism.2019; 12(2): 211. CrossRef - Socioeconomic inequalities in relation to health and nutrition literacy in Greece
Maria Michou, Demosthenes B. Panagiotakos, Christos Lionis, Vassiliki Costarelli
International Journal of Food Sciences and Nutrition.2019; 70(8): 1007. CrossRef - Dietary Patterns and Their Association with Anxiety Symptoms among Older Adults: The ATTICA Study
Maria F. Masana, Stefanos Tyrovolas, Natasa Kollia, Christina Chrysohoou, John Skoumas, Josep Maria Haro, Dimitrios Tousoulis, Charalambos Papageorgiou, Christos Pitsavos, Demosthenes B. Panagiotakos
Nutrients.2019; 11(6): 1250. CrossRef - Excess body weight and abdominal obesity in relation to selected psychosocial characteristics in primary school children
Ioannis Vassiloudis, Vassiliki Costarelli
Nutrition & Food Science.2019; 50(4): 739. CrossRef - Alarming endoscopic data in young and older asymptomatic people: Results of an open access, unlimited age colonoscopic screening for colorectal cancer
Vasileios Panteris, Nikolaos Vasilakis, Maria Demonakou, Eleni Kornarou, Eftyxios Ktenas, Emanuella Rapti, George Spithakis, Konstantina Katopodi, Maria Horti, Stefani Vgenopoulou, John Triantafyllidis, Apostolos Papalois, Panagiotis Karantan
Molecular and Clinical Oncology.2019;[Epub] CrossRef - Demographic-Specific Rates for Life Events in the Cardiovascular Health Study and Comparisons With Other Studies
Peter P Vitaliano, Annette L Fitzpatrick, Lee E Williams, Michalina A Montano, Joan E Russo
Innovation in Aging.2018;[Epub] CrossRef - Socioeconomic status and impact of the economic crisis on dietary habits in Italy: results from the INHES study
Marialaura Bonaccio, Augusto Di Castelnuovo, Americo Bonanni, Simona Costanzo, Mariarosaria Persichillo, Chiara Cerletti, Maria Benedetta Donati, Giovanni de Gaetano, Licia Iacoviello
Journal of Public Health.2018; 40(4): 703. CrossRef - Impact of the financial crisis on COPD burden: Greece as a case study
Ourania S. Kotsiou, Spyridon Zouridis, Marinos Kosmopoulos, Konstantinos I. Gourgoulianis
European Respiratory Review.2018; 27(147): 170106. CrossRef - Ten-Year Trends (1999–2010) of Adherence to the Mediterranean Diet among the Balearic Islands’ Adult Population
Maria Bibiloni, Mónica González, Alicia Julibert, Isabel Llompart, Antoni Pons, Josep Tur
Nutrients.2017; 9(7): 749. CrossRef - Metabolic profile of the Mediterranean healthy Eating, Lifestyle and Aging (MEAL) study cohort
Antonio Mistretta, Stefano Marventano, Alessio Platania, Justyna Godos, Fabio Galvano, Giuseppe Grosso
Mediterranean Journal of Nutrition and Metabolism.2017; 10(2): 131. CrossRef - The prevalence of depression in rheumatoid arthritis in China: A systematic review
Xin Fu, Zhi-Jun Li, Chun-Jun Yang, Liangshu Feng, Lemeng Sun, Yang Yao, Yu-Ting Huang
Oncotarget.2017; 8(32): 53623. CrossRef
- The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study
-
Venetia Notara, Demosthenes B. Panagiotakos, Yannis Kogias, Petros Stravopodis, Antonis Antonoulas, Spyros Zombolos, Yannis Mantas, Christos Pitsavos
-
J Prev Med Public Health. 2016;49(4):220-229. Published online June 24, 2016
-
DOI: https://doi.org/10.3961/jpmph.16.005
-
-
10,991
View
-
133
Download
-
18
Crossref
-
Abstract
PDF
- Objectives
The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated.
Methods
From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient’s educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years).
Results
Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed.
Conclusions
A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.
-
Summary
-
Citations
Citations to this article as recorded by - Socioeconomic disparities and risk of recurrent cardiovascular events and cardiovascular disease-free life expectancy in patients with established cardiovascular disease
Stella Bijkerk, Frank L J Visseren, Manon G van der Meer, Gert J de Borst, Ynte M Ruigrok, Tomas Jernberg, Mark Woodward, Eric P Moll van Charante, Ilonca Vaartjes, Jannick A N Dorresteijn, Steven H J Hageman, M J Cramer, M G van der Meer, P van der Harst
European Journal of Preventive Cardiology.2025;[Epub] CrossRef - Time-Dependent Risk for Recurrence in Survivors of Major Adverse Cardiovascular Events
Anderson Bermon, Belem Trejo-Valdivia, Carlos Federico Molina Castaño, Angela M Segura, Norma C Serrano
Cureus.2024;[Epub] CrossRef - The impact of education level on all-cause mortality in patients with atrial fibrillation
Áron Sztaniszláv, Anna Björkenheim, Anders Magnuson, Ing-Liss Bryngelsson, Nils Edvardsson, Dritan Poci
Scientific Reports.2024;[Epub] CrossRef - Temporal trends in socioeconomic disparity in clinical outcomes for patients with acute coronary syndrome
Amalie H. Simoni, Jan B. Valentin, Kristian H. Kragholm, Henrik Bøggild, Svend E. Jensen, Søren P. Johnsen
Cardiovascular Revascularization Medicine.2023; 56: 64. CrossRef - Associations of Recreational and Nonrecreational Physical Activity and Body Weight Change on Cardiovascular Disease Mortality During the Obesogenic Transition in the United States: National Health and Nutrition Examination Survey Follow-up Study
Birinder S. Cheema, Zumin Shi, Rhiannon L. White, Evan Atlantis
Journal of Physical Activity and Health.2023; 20(10): 971. CrossRef - Socioeconomic inequity in incidence, outcomes and care for acute coronary syndrome: A systematic review
Amalie H. Simoni, Juliane Frydenlund, Kristian H. Kragholm, Henrik Bøggild, Svend E. Jensen, Søren P. Johnsen
International Journal of Cardiology.2022; 356: 19. CrossRef - Low educational status correlates with a high incidence of mortality among hypertensive subjects from Northeast Rural China
Shasha Yu, Xiaofan Guo, GuangXiao Li, Hongmei Yang, Liqiang Zheng, Yingxian Sun
Frontiers in Public Health.2022;[Epub] CrossRef - Adherence to the Mediterranean diet according to occupation-based social classifications and gender
Carlos Álvarez-Fernández, Manuel Romero-Saldaña, Álvaro Álvarez-López, Rafael Molina-Luque, Guillermo Molina-Recio, Manuel Vaquero-Abellán
Archives of Environmental & Occupational Health.2021; 76(5): 275. CrossRef - Irrational beliefs trigger depression and anxiety symptoms, and associated with increased inflammation and oxidative stress markers in the 10-year diabetes mellitus risk: the ATTICA epidemiological study
Christina Vassou, Ekavi N. Georgousopoulou, Christina Chrysohoou, Mary Yannakoulia, Christos Pitsavos, Mark Cropley, Demosthenes B. Panagiotakos
Journal of Diabetes & Metabolic Disorders.2021; 20(1): 727. CrossRef - Association between Educational Level and Physical Activity in Chronic Disease Patients of Eastern Slovakia
Alena Buková, Erika Chovanová, Zuzana Küchelová, Jan Junger, Agata Horbacz, Mária Majherová, Silvia Duranková
Healthcare.2021; 9(11): 1447. CrossRef - Trajectories of Outpatient Service Utilisation of Hypertensive Patients in Tertiary Hospitals in China
Zijing Pan, Wanchun Xu, Zhong Li, Chengzhong Xu, Fangfang Lu, Pei Zhang, Liang Zhang, Ting Ye
International Journal of Environmental Research and Public Health.2020; 17(3): 852. CrossRef - Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-analysis
Lingqian Xu, Debapriya Mondal, David A. Polya
International Journal of Environmental Research and Public Health.2020; 17(7): 2536. CrossRef - Association of low-level inorganic arsenic exposure from rice with age-standardized mortality risk of cardiovascular disease (CVD) in England and Wales
Lingqian Xu, David A. Polya, Qian Li, Debapriya Mondal
Science of The Total Environment.2020; 743: 140534. CrossRef - Relevant problems of participation and education of patients in cardiac rehabilitation and secondary prevention programs
M. G. Bubnova
Cardiovascular Therapy and Prevention.2020; 19(6): 2649. CrossRef - Study of awareness of risk factors and attitudes towards health in patients with coronary heart disease. New rehabilitation counseling technology: the first experience
M. G. Bubnova, D. M. Aronov, N. K. Novikova, E. M. Rodzinskaya, A. L. Persiyanova-Dubrova
Profilakticheskaya meditsina.2019; 22(4): 114. CrossRef - Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium
Keming Yang, Ying Zhang, Eiko Saito, Md Shafiur Rahman, Prakash Chandra Gupta, Norie Sawada, Akiko Tamakoshi, Yu-Tang Gao, Woon-Puay Koh, Xiao-Ou Shu, Ichiro Tsuji, Atsuko Sadakane, Chisato Nagata, San-Lin You, Jian-Min Yuan, Myung-Hee Shin, Yu Chen, Wen-
BMJ Open.2019; 9(8): e026225. CrossRef - Prevalence and risk factors for prehypertension and hypertension among adults in Central China from 2000-2011
Chaoying Chen, Zhanpeng Yuan
Clinical and Experimental Hypertension.2018; 40(8): 734. CrossRef - The risk factors of 9-year follow-up on hypertension in middle-aged people in Tujia-Nationality settlement of China
X Liu, C Liu, H Schenck, X Yi, H Wang, X Shi
Journal of Human Hypertension.2017; 31(12): 838. CrossRef
|
KSPM
